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护理研究

慢性肾脏病患者味觉改变的Meta分析和系统性评价

  • 吴夏鑫 ,
  • 施月仙 ,
  • 范亚茹 ,
  • 李霁月
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  • 100191 北京,1北京大学护理学院

收稿日期: 2023-04-27

  修回日期: 2023-05-26

  网络出版日期: 2023-09-12

基金资助

北京大学“未名护理”领军人才科研创新基金孵化项目(LJRC21YB03)

A meta-analysis and systematic review of taste alteration in adult patients with chronic kidney disease

  • WU Xia-Xin ,
  • SHI Yue-Xian ,
  • FAN Ya-Ru ,
  • LI Ji-Yue
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  • School of Nursing, Peking University, Beijing 100191, China

Received date: 2023-04-27

  Revised date: 2023-05-26

  Online published: 2023-09-12

摘要

目的  Meta分析慢性肾脏病患者味觉改变的发生风险,整合味觉改变的发生率。 方法 计算机检索中国知网、万方数据库、Pubmed、Embase和Web of science数据库,搜集有关慢性肾脏病患者味觉改变的研究,检索时限均从建库至2023年1月31日。由2位研究员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 17.0软件进行Meta分析。 结果 共纳入13个研究,包括4090例患者。Meta分析结果发现慢性肾脏病患者味觉改变较非疾病暴露人群发生风险高(OR=6.262,95% CI:1.556~25.197),总发生率为29.6%(ES=0.296,95% CI:0.209~0.390)。eGFR<20 ml/(min·1.73m2)的患者味觉改变发生率为33.5%(ES=0.335,95% CI:0.285~0.386),高于eGFR≥20 ml/(min·1.73m2)的患者(20.0%,ES=0.200,95% CI:0.047~0.353)。使用客观测评工具的味觉改变筛查结果为43.3%(ES=0.433,95% CI:-0.058~0.923),高于使用主观测评工具(27.9%,ES=0.279,95% CI:0.189~0.368)。发展中国家报道CKD患者味觉改变发生率为46.4%(ES=0.464,95% CI:0.125~0.802),高于发达国家报道的结果(23.6%,ES=0.236,95% CI:0.148~0.324)。汇总文献结果发现年龄、性别、营养相关血生化标志物以及胃肠消化道症状与味觉改变有关。 结论 慢性肾脏病患者发生味觉改变的风险高,且随疾病进展报告率增加,不同经济水平国家间报告差异明显。味觉改变的发生影响进食、营养、消化等,结合主客观测评工具开展临床评估,尤其关注高龄、女性和潜在营养不良人群,可为早期识别味觉改变和开展干预提供帮助。

本文引用格式

吴夏鑫 , 施月仙 , 范亚茹 , 李霁月 . 慢性肾脏病患者味觉改变的Meta分析和系统性评价[J]. 中国血液净化, 2023 , 22(09) : 715 -720 . DOI: 10.3969/j.issn.1671-4091.2023.09.018

Abstract

Objective  A meta-analysis was performed to analyze the risk of taste alteration and to integrate the prevalence of taste alteration in chronic kidney disease (CKD) patients.  Methods  CNKI, Wanfang Database, PubMed, Embase, and Web of Science were searched from the date of database establishment to January 31, 2023 to collect the studies on taste changes in CKD patients. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias of the included studies. Stata 17.0 software was used for the meta-analysis.  Results  A total of 13 studies were included, including 4,090 patients. The results of meta-analysis showed that the risk odds ratio of CKD patient with taste alteration was 6.262 (95% CI 1.556~25.197), and the overall prevalence of taste alteration in CKD patients was 29.6% (ES=0.296, 95% CI 0.209~0.390). The incidence of taste alteration was 33.5% (ES=0.335, 95% CI 0.285~0.386) in patients with eGFR<20ml/min/1.73m2, and was 20.0% (ES=0.200, 95% CI 0.047~0.353) in patients with eGFR≥20ml/min/1.73m2. The incidence of taste alteration was 43.3% (ES=0.433, 95% CI -0.058~0.923) screening by objective assessment tools, and was 27.9% (ES=0.279, 95% CI 0.189~0.368) screening by subjective assessment tools. The incidence of taste alteration was 46.4% (ES=0.464, 95% CI 0.125~0.802) reported in developing countries, and was 23.6% (ES=0.236, 95% CI 0.148~0.324) reported in developed countries. Integration of the literature showed that age, sex, nutrition-related blood biochemical markers and gastrointestinal symptoms were related to taste alteration.  Conclusion  CKD patients have a high risk of taste alteration. The reported rate increases with disease progression, and is significant different among countries with different economic levels. The taste alteration affects eating, nutrition, digestion, and others. Clinical evaluation of the taste changes should be carried out by combining subjective and objective assessment tools, especially focusing on the elderly, women and potentially malnourished people, to early identify and intervene the taste changes.

参考文献

[1]PUGH-CLARKE K, READ S C, SIM J.Symptom experience in non-dialysis-dependent chronic kidney disease: A qualitative descriptive study[J].J Ren Care, 2017, 43(4):197-208 [2]MEADE A, LE LEU R, WATSON N, et al.Gastrointestinal symptom burden and dietary intake in patients with chronic kidney disease[J].JOURNAL OF RENAL CARE, 2021, 47(4):234-41 [3]VESTERINEN M, RUOKONEN H, FURUHOLM J, et al.Clinical questionnaire study of oral health care and symptoms in diabetic vsnon-diabetic predialysis chronic kidney disease patients[J].Clin Oral Investig, 2012, 16(2):559-63 [4]LYNCH K E, LYNCH R, CURHAN G C, et al.Altered taste perception and nutritional status among hemodialysis patients[J].J Ren Nutr, 2013, 23(4):288-95 [5]JEON S, KIM Y, MIN S, et al.Taste Sensitivity of Elderly People Is Associated with Quality of Life and Inadequate Dietary Intake [J]. [J].NUTRIENTS, 2021, 13(5):- [6]MANLEY K J.Taste genetics and gastrointestinal symptoms experienced in chronic kidney disease[J].EUROPEAN JOURNAL OF CLINICAL NUTRITION, 2015, 69(7):781-5 [7]MAHMUT M K, BANZER B.Exploring the Relationship Between Psychopathy and Taste Perception[J].CHEMOSENSORY PERCEPTION, 2021, 14(1):47-56 [8]ALIA S, AQUILANTI L, PUGNALONI S, et al.The Influence of Age and Oral Health on Taste Perception in Older Adults: A Case-Control Study [J]. [J].NUTRIENTS, 2021, 13(11):- [9]CHEN S I, CHIANG C L, CHAO C T, et al.Gustatory Function and the Uremic Toxin, Phosphate, Are Modulators of the Risk of Vascular Calcification among Patients with Chronic Kidney Disease: A Pilot Study [J].[J].TOXINS, 2020, 12(6):- [10]DAWSON J, BRENNAN F P, HOFFMAN A, et al.Prevalence of Taste Changes and Association with Other Nutrition-Related Symptoms in End-Stage Kidney Disease Patients[J].JOURNAL OF RENAL NUTRITION, 2021, 31(1):80-4 [11]TAN S Y, TULI P, THIO G, et al.A Systematic Review of Salt Taste Function and Perception Impairments in Adults with Chronic Kidney Disease [J].[J]. Int J Environ Res Public Health, 2022, 19(19):- [12]HU J R, MYINT L, LEVEY A S, et al.A metabolomics approach identified toxins associated with uremic symptoms in advanced chronic kidney disease[J].KIDNEY INTERNATIONAL, 2022, 101(2):369-78 [13]CHEWCHARAT A, PHIPPS E A, BHATIA K, et al.The association between olfactory and gustatory dysfunction and chronic kidney disease [J].[J]. BMC NEPHROLOGY, 2022, 23(1):- [14]YUSUF T, RAJI Y R, LASISI T J, et al.Predictors of Taste Dysfunction and Its Severity Among Patients With Chronic Kidney Disease [J]. [J].ENT-EAR NOSE & THROAT JOURNAL, 2021, :- [15]CHEN S I, CHIANG C L, CHAO C T, et al.Gustatory Dysfunction Is Closely Associated With Frailty in Patients With Chronic Kidney Disease[J].JOURNAL OF RENAL NUTRITION, 2021, 31(1):49-56 [16]FITZGERALD C, WIESE G, MOORTHI R N, et al.Characterizing Dysgeusia in Hemodialysis Patients[J].CHEMICAL SENSES, 2019, 44(3):165-71 [17]OYETOLA E O, OWOTADE F J, AGBELUSI G A, et al.Oral findings in chronic kidney disease: implications for management in developing countries [J]. [J].BMC ORAL HEALTH, 2015, 15:- [18]DE LA ROSA GARCíA E, MONDRAGóN PADILLA A, ARANDA ROMO S, et al.Oral mucosa symptoms,signs and lesions,in end stage renal disease and non-end stage renal disease diabetic patients[J].Med Oral Patol Oral Cir Bucal, 2006, 11(6):E467-73 [19]BOTS C P, POORTERMAN J H, BRAND H S, et al.The oral health status of dentate patients with chronic renal failure undergoing dialysis therapy[J].Oral Dis, 2006, 12(2):176-80 [20]KHO H S, LEE S W, CHUNG S C, et al.Oral manifestations and salivary flow rate,pH,and buffer capacity in patients with end-stage renal disease undergoing hemodialysis[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1999, 88(3):316-9 [21]PRECONE V, BECCARI T, STUPPIA L, et al.Taste,olfactory and texture related genes and food choices: implications on health status[J].European review for medical and pharmacological sciences, 2019, 23(3):1305-21 [22]ROPER S D, CHAUDHARI N.Taste buds: cells,signals and synapses[J].Nature Reviews Neuroscience, 2017, 18(8):485-97 [23]PENG Y, GILLIS-SMITH S, JIN H, et al.Sweet and bitter taste in the brain of awake behaving animals[J].Nature, 2015, 527(7579):512-5 [24]BRENNAN F, STEVENSON J, BROWN M.The Pathophysiology and Management of Taste Changes in Chronic Kidney Disease: A Review[J].JOURNAL OF RENAL NUTRITION, 2020, 30(5):368-79 [25]KALANTAR-ZADEH K, LOCKWOOD M B, RHEE C M, et al.Patient-centred approaches for the management of unpleasant symptoms in kidney disease[J].NATURE REVIEWS NEPHROLOGY, 2022, 18(3):185-98 [26]Managing taste changes in advanced CKD [Z].Australia; New South Wales Ministry of Health. 2017 [27]BRENNAN F, DAWSON J, BROWN M A.A Novel Clinical Tool for the Management of Taste Changes in Patients With Chronic Kidney Disease: The Chronic Kidney Disease Taste Plate[J].J Ren Nutr, 2022, 32(4):483-8 [28]SCHIFFMAN S S.Taste and smell losses in normal aging and disease[J].Jama, 1997, 278(16):1357-62 [29]YOSHINAKA M, IKEBE K, UOTA M, et al.Age and sex differences in the taste sensitivity of young adult,young-old and old-old Japanese[J].Geriatr Gerontol Int, 2016, 16(12):1281-8 [30]IANNILLI E, BROY F, KUNZ S, et al.Age-related changes of gustatory function depend on alteration of neuronal circuits[J].J Neurosci Res, 2017, 95(10):1927-36 [31]DUNCANSON E, CHUR-HANSEN A, JESUDASON S.Psychosocial consequences of gastrointestinal symptoms and dietary changes in people receiving automated peritoneal dialysis[J].JOURNAL OF RENAL CARE, 2019, 45(1):41-50 [32]VINCIS R, FONTANINI A.Central taste anatomy and physiology [J]. [J].Handb Clin Neurol, 2019, 164:187-204 [33]SALAZAR-ROBLES E, LERMA A, CALDERON-JUAREZ M, et al.Assessment of Factors Related to Diminished Appetite in Hemodialysis Patients with a New Adapted and Validated Questionnaire [J].[J]. NUTRIENTS, 2021, 13(4):- [34]ROGERS N.Why illness might leave a bitter taste in the mouth [J]. [J].Nature, 2015, :- [35]SAHATHEVAN S, KHOR B H, NG H M, et al.Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review [J].[J]. NUTRIENTS, 2020, 12(10):- [36]SLEE A, REID J.Disease-related malnutrition in chronic kidney disease[J].Curr Opin Clin Nutr Metab Care, 2022, 25(3):136-41 [37]邱慧敏, 廉嘉欣, 程巧芬, 等.人的味觉敏感性测定方法研究进展[J].食品工业科技, 2022, 43(15):401-8 [38]ENRIQUEZ-FERNANDEZ B E, MARTINEZ-MICHEL L, THORLAKSON J, et al.Patient-reported taste change assessment questionnaires used in the oncology setting: A narrative review [J].[J]. European Journal of Oncology Nursing, 2020, 47:101775-
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